Clinical Research Directory

Inclusion Criteria: * Histologically-proven primary head and neck ACC; * Unresectable stage or residual macroscopic disease after surgery or multiple microscopic margins after surgery; * Patient with resectable tumor but refusing surgery * cN0/pN0 - cN1/pN1 patients (only ipsilateral neck levels I and II) * Absence of distant metastases or oligometastatic status (patients with ≤ 3 metastatic lung or bone lesions, excluding other sites; * No previous radiotherapy in head and neck region; * Karnofsky Performance Status ≥ 70; * Age ≥ 18 years; * Written informed consent * Patients' ability to understand the characteristics and consequences of the clinical trial. Exclusion Criteria: * Local conditions contraindicating CIRT (e.g., active infection or previous history of recurrent infections in or close to the tumor site; intratumoral necrosis in strict proximity of vessels; pre-existing skin, bone or soft tissue fistula; extended mucosal involvement by the tumor; previous surgery with flap reconstruction); * Tumour site in nasopharynx, pharynx and tongue base (where an exclusive CIRT treatment could be at high risk of toxicity); * Tumor disease involving ≥ 50% of the palate with consequent high risks of serious anatomical damage in case of significant and rapid disease response to CIRT * Nodal involvement \> cN1/pN1 or cN1/pN1 outside ipsilateral levels I and II * Tumor surrounding carotid artery \> 180° or infiltrating the vessels * itanium surgical implants or metal prostheses or any other condition that prevents adequate imaging to identify the target volume and may determine uncertainties in CIRT dose distribution during treatment planning * Presence of any comorbidity deemed to impact on treatment toxicity; * Psychic or other disorders that may prevent informed consent * Active autoimmune disease (e.g. systemic lupus erythematosus, systemic sclerosis, rheumatoid arthritis) * Contraindication to MRI * Pregnancy or breastfeeding in progress